MSN 5410 ADVANCED MEDICAL SURGICAL NURSING LATEST
EXAM 58 REAL EXAM QUESTIONS AND ANSWERS PLUS
MARKING SCHEME
What are primary ways to prevent cancer? - ANSWER: - Avoidance of known or
potential carcinogens
- Modification of associated factors
- Removal of "at-risk" tissues
- Chemoprevention
- Vaccination
Secondary cancer prevention methods - ANSWER: - Use of screening methods to
detect cancer in early stages
- genetic screening for individuals with increased risk
TNM system - ANSWER: T- tumor size
N- node involvement
M- metastasis
Radiation therapy - ANSWER: - used to destroy cancer cells with minimal damage to
surrounding normal/healthy cells
- can be done externally (teletherapy) or internally (brachytherapy)
Side Effects of radiation therapy - ANSWER: - altered taste & fatigue
- skin reactions
- anorexia
- bone marrow suppression/myelosuppression
- effects on rapidly diving cells (skin, mucous membranes, hair follicles, sperm, ova)
- xerostomia, mucositis
Nursing Interventions for patients receiving radiation therapy - ANSWER: - Monitor
CBC
- monitor for signs of infection, bleeding, & fatigue
- do NOT remove markings
- ensure pt. can swallow
- perform skin care/apply sunscreen
- teach pt. to avoid things that could cause fx to bones
Nursing Management of patient with xerostomia/mucositis - ANSWER: - regular
dental visits
- good oral care/hygiene
- prophylactic atbx for dental procedures
Patient Teaching for xerostomia/mucositis - ANSWER: - Soft-bristled toothbrush, or
disposable mouth sponges.
- gentle flossing daily.
, - Rinse mouth w/ h2o or saline every hour while awake. - Avoid mouthwashes that
contain alcohol or other drying agents.
- Need to keep oral hygiene equipment like toothbrushes clean. Toothbrushes can be
ran through the dishwasher or rinsed with bleach & then water.
What is the most common reason for adjusting chemo doses? - ANSWER: - bone
marrow suppression/myelosuppression
Side effects of chemotherapy - ANSWER: - bone marrow suppression=infection risk
- alopecia
- CINV
- mucositis
- changes in LOC
- peripheral neuropathy
Nursing care for alopecia - ANSWER: - hair growth usually begins about 1 month
after completion of chemo. As hair grows back in the new hair may be different in
color, texture, & thickness.
- teach the pt to protect the scalp from injury from sun exposure & wear head
coverings under helmets, etc.
- Suggest pt purchase a wig before chemo begins & have their hairdresser shape the
wig to mimic their usual hair style so there is less change in appearance.
Nuring Care & Patient Teaching about Chemo Brain - ANSWER: - some pts report
changes in cognitive function, chemo brain.
- While it is happening have pt use planner to help with remembering things.
- monitor LOC
Oncologic Emergencies - ANSWER: - Sepsis
- DIC
- Bowel obstruction
- SIADH
- Superior vena cava syndrome
- hypercalcemia
- tumor lysis syndrome
- spinal cord compression
What is tumor lysis syndrome? - ANSWER: - usually occurs after 1st dose of radiation
chemo
- occurs d/t large #s of tumor cells being destroyed rapidly
- the intracellular contents get released into bloodstream faster than the body can
eliminate them
- this can result in hyperkalemia & gout
Signs & Symptoms of hyperkalemia - ANSWER: - think CARDIAC
- palpitations/slow irregular pulse
- fatigue
EXAM 58 REAL EXAM QUESTIONS AND ANSWERS PLUS
MARKING SCHEME
What are primary ways to prevent cancer? - ANSWER: - Avoidance of known or
potential carcinogens
- Modification of associated factors
- Removal of "at-risk" tissues
- Chemoprevention
- Vaccination
Secondary cancer prevention methods - ANSWER: - Use of screening methods to
detect cancer in early stages
- genetic screening for individuals with increased risk
TNM system - ANSWER: T- tumor size
N- node involvement
M- metastasis
Radiation therapy - ANSWER: - used to destroy cancer cells with minimal damage to
surrounding normal/healthy cells
- can be done externally (teletherapy) or internally (brachytherapy)
Side Effects of radiation therapy - ANSWER: - altered taste & fatigue
- skin reactions
- anorexia
- bone marrow suppression/myelosuppression
- effects on rapidly diving cells (skin, mucous membranes, hair follicles, sperm, ova)
- xerostomia, mucositis
Nursing Interventions for patients receiving radiation therapy - ANSWER: - Monitor
CBC
- monitor for signs of infection, bleeding, & fatigue
- do NOT remove markings
- ensure pt. can swallow
- perform skin care/apply sunscreen
- teach pt. to avoid things that could cause fx to bones
Nursing Management of patient with xerostomia/mucositis - ANSWER: - regular
dental visits
- good oral care/hygiene
- prophylactic atbx for dental procedures
Patient Teaching for xerostomia/mucositis - ANSWER: - Soft-bristled toothbrush, or
disposable mouth sponges.
- gentle flossing daily.
, - Rinse mouth w/ h2o or saline every hour while awake. - Avoid mouthwashes that
contain alcohol or other drying agents.
- Need to keep oral hygiene equipment like toothbrushes clean. Toothbrushes can be
ran through the dishwasher or rinsed with bleach & then water.
What is the most common reason for adjusting chemo doses? - ANSWER: - bone
marrow suppression/myelosuppression
Side effects of chemotherapy - ANSWER: - bone marrow suppression=infection risk
- alopecia
- CINV
- mucositis
- changes in LOC
- peripheral neuropathy
Nursing care for alopecia - ANSWER: - hair growth usually begins about 1 month
after completion of chemo. As hair grows back in the new hair may be different in
color, texture, & thickness.
- teach the pt to protect the scalp from injury from sun exposure & wear head
coverings under helmets, etc.
- Suggest pt purchase a wig before chemo begins & have their hairdresser shape the
wig to mimic their usual hair style so there is less change in appearance.
Nuring Care & Patient Teaching about Chemo Brain - ANSWER: - some pts report
changes in cognitive function, chemo brain.
- While it is happening have pt use planner to help with remembering things.
- monitor LOC
Oncologic Emergencies - ANSWER: - Sepsis
- DIC
- Bowel obstruction
- SIADH
- Superior vena cava syndrome
- hypercalcemia
- tumor lysis syndrome
- spinal cord compression
What is tumor lysis syndrome? - ANSWER: - usually occurs after 1st dose of radiation
chemo
- occurs d/t large #s of tumor cells being destroyed rapidly
- the intracellular contents get released into bloodstream faster than the body can
eliminate them
- this can result in hyperkalemia & gout
Signs & Symptoms of hyperkalemia - ANSWER: - think CARDIAC
- palpitations/slow irregular pulse
- fatigue
